One of the most serious injuries of childbirth, obstetric fistula is a hole in the birth canal caused by prolonged, obstructed labour due to the lack of timely and adequate medical care. In most cases, the baby is either stillborn or dies within the first week of life, and the woman suffers a devastating injury—a fistula—that renders her incontinent. Many women and girls with fistula are shunned by their families and communities, deepening their poverty and magnifying their suffering.

“It is unconscionable that the poorest, most vulnerable women and girls suffer needlessly from the devastating condition of obstetric fistula,” says Dr. Babatunde Osotimehin, Executive Director of UNFPA, the United Nations Population Fund. “These vulnerable women and girls are at the heart of UNFPA’s efforts to ensure that every pregnancy is wanted, every child birth is safe, and every young person’s potential is fulfilled.”

Victims of obstetric fistula are usually among the hardest to reach, and are often illiterate and with limited access to health services, including maternal and reproductive health care. The persistence of the problem reflects broader health inequities and health-care system weaknesses, as well as wider challenges facing women and girls, such as gender and socio-economic inequality, lack of schooling, child marriage and early child bearing—all of which impede the well-being of women and girls and their opportunities.

Obstetric fistula has been virtually eliminated in industrialized nations, as it is preventable and, in most cases, can be surgically repaired. However, an estimated 2 to 3 million women and girls still live with the condition in the developing world, and more than 50,000 new cases develop each year.

Over the last 10 years, UNFPA has directly supported more than 34,000 women and girls to receive surgical treatment for fistula—roughly one third of global repairs—including 7,000 women and girls in 2012 alone. Partner agencies have supported thousands more as part of the Campaign to End Fistula, which was launched in 2003 by UNFPA and a wide range of partners. The Campaign is based on the three key strategies of prevention, treatment and social reintegration of survivors. Uniting more than 80 international partner agencies and hundreds more at national and community levels, the Campaign has tripled in size since its inception and is currently active in more than 50 countries in Africa, Asia, the Arab states and Latin America.

Ground breaking initiatives across the globe, including the most remote and challenging contexts, are changing the futures of women and girls suffering from fistula. One such initiative is the partnership between Vodafone and the Comprehensive Community Based Rehabilitation (CCBRT) Hospital in Tanzania. To help patients pay for their trips to the hospital where they receive fistula repairs, CCBRT in 2009 started using Vodafone’s banking system through which the hospital transfers money via SMS to community ambassadors who, in turn, buy bus fares for patients who cannot afford the trip. This has resulted in an increase in the number of patients seeking fistula treatment at CCBRT, from about 150 in 2009 to more than 500 in 2012.

Last year, the General Assembly designated 23 May as the official International Day to End Obstetric Fistula. Events on that day will include a special observance at the United Nations in New York, with the participation of fistula survivors, advocates and practitioners who have dedicated their careers to putting an end to this devastating condition. In addition, Campaign partners and UNFPA will kick off a multitude of events around the world in support of the fight to end this grave global injustice once and for all.

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